Codeine Plus Acetaminophen Improve Sleep Quality, Daily Activity Level, and Food Intake in the Early Postoperative Period After Photorefractive Keratectomy: A Secondary Analysis


Main idea: The oral combination of codeine and acetaminophen significantly improves sleep quality and daily activity level within the first 24-72 h post-photorefractive keratectomy compared to a placebo.


The purpose of the study was to determine whether codeine plus acetaminophen after photorefractive keratectomy (PRK) have beneficial effects on sleep quality, activity levels, and food intake, beyond their effect of pain relief.

40 patients (80 eyes) in this randomized double-blind paired-eye placebo-controlled add-on trial. Each eye was treated 2 weeks apart, and the patients were randomly allocated to receive either the placebo or the intervention (30 mg codeine and 500 mg acetaminophen) 4 times a day for 4 days.

Results: Sleep quality and daily activity level were inversely associated with pain scores within the first 48 h post-photorefractive keratectomy. During the intervention, patients were significantly more likely to score their sleep quality as ‘good’ at 24 h and 48 h compared to during placebo. The probability of reporting good daily activity level at 24 and 72 h post-photorefractive keratectomy was three times higher when patients received the intervention compared to the placebo. No difference was observed in food intake.


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